1,721,293 research outputs found
L'evoluzione dei sistemi contabili pubblici: aspetti critici nella prospettiva aziendale
No full textLe innovazioni nei sistemi e nelle tecniche contabili rappresentano un aspetto fondamentale delle riforme che, a partire dagli anni Ottanta, hanno interessato le aziende pubbliche. Tra tali innovazioni, particolare rilievo ha assunto l'introduzione della contabilità economico-patrimoniale. Il libro discute l'opportunità di tale introduzione, a integrazione o in sostituzione della tradizionale contabilità finanziaria. Ciò porta a identificare e approfondire tre ulteriori criticità. La prima riguarda la funzione dell'informativa di bilancio: si può estendere alle aziende pubbliche il concetto di "utilità a fini decisionali"? Chi ha teoricamente interesse, o comunque diritto, alle informazioni contabili relative alle aziende pubbliche? Cosa si deve fare per stimolare l'effettivo interesse o tutelarne concretamente i diritti? La seconda criticità riguarda la finalità autorizzativa: è possibile riprodurre o sostituire adeguatamene la funzione autorizzariva del sistema contabile in un'azienda pubblica dotata della sola contabilità economico-patrimoniale? La terza criticità riguarda il quadro concettuale su cui si fonda l'informativa di bilancio: quali modifiche è necessario apportare al modello di bilancio d'esercizio, in termini di concetti fondamentali e di modalità di determinazione, presentazione e interpretazione dei valori, per renderlo coerente con le spcificità delle aziende pubbliche
The effect of user charges on the utilisation of prescription medicines in the Italian National Health Service
No full textIn Italy, public spending on outpatient prescription medicines has traditionally accounted for a large percentage of health-care expenditures (15% in 1992). Since its inception in 1978, therefore, the Italian National Health Service (INHS) has used user charges and several other regulatory measures to curb expenditures. Since 1978, moreover, these measures have been revised several times. Their impact on utilisation, however, has been the subject of remarkably little work. This dissertation begins to fill this void with specific respect to cardiovasculars, which account for 23% of total INHS drug expenditures. The data set for the empirical analysis was provided by the Emilia-Romagna Regional Health Authority. The unit of observation is total consumption of a given pharmaceutical product by District by month. The data set covers 18 Districts over 60 months, between January 1989 and December 1993. The econometric specification is based on Deaton and Muellbauer's Almost Ideal Demand System. The model has been estimated both in levels and in first differences. The main result is that price does affect utilisation. For cardiovasculars as a whole, the estimated price elasticity is 0.30 to 0.36. This is a rather large estimate, especially for cardiovasculars. The presence of large own-price elasticities has a number of important policy implications. First, drug copayments cannot be viewed solely as a way of raising additional government revenues. In addition, price deregulation may lead to smaller price increases than expected. Finally, the introduction of reference pricing may prove an extremely powerful price-containment mechanism. Naturally, the welfare implications of these estimates cannot be fully assessed without some information on health outcomes. Other significant results may be summarised as follows. First, changes in copayment exemption regimes do affect utilisation but may have a greater impact in the short than in the medium run. Second, own-price elasticities vary significantly across pharmaceutical groups, with smaller elasticities for necessary drugs of proven efficacy. Third, income has a significantly positive effect on utilisation, with an estimated elasticity of 0.30. Finally, utilisation is also affected by physician characteristics such as seniority and densit
Principles of public management
No full textIs it possible to reform public administration? Can management theory help? If so, why is the recent wave of managerial reforms (often lumped together under the umbrella term of «New Public Management» or «NPM») so widely criticised? Are private and public management somewhat similar, or are they fundamentally alike only in all unimportant respects?
The purpose of this book is to present a theory of public management and then to combine a deductive approach (from the theory’s first principles) and an inductive approach (from the observation of actual applications of managerial concepts and techniques) to derive propositions and considerations about the different components of a government entity.
Chapters 1 and 2 present the theoretical framework. Chapters 3 and 4 analyse the activities carried out by governments, their stakeholders and governance structures, their relationships with other entities. Chapters 5 and 6 investigate the implications for governments’ organisational structures; personnel management systems; planning, programming, measurement and control systems.
The book may be used for undergraduate and graduate courses in public management. However, it also aims at (i) providing an alternative view on public-sector reforms, thus making a contribution to the academic debate; and (ii) supporting managers and professionals (e.g., consultants) that are already operating in the public sector or are planning to do s
Il nuovo sistema di finanziamento delle aziende sanitarie: implicazioni per la medicina interna
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